Provider Demographics
NPI:1346741154
Name:SPGI SNF LLC
Entity Type:Organization
Organization Name:SPGI SNF LLC
Other - Org Name:THE NURSING CENTER AT UNIVERSITY VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALTZLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-782-6364
Mailing Address - Street 1:12250 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4955
Mailing Address - Country:US
Mailing Address - Phone:407-782-6364
Mailing Address - Fax:407-209-3541
Practice Address - Street 1:12250 N 22ND ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4955
Practice Address - Country:US
Practice Address - Phone:407-782-6364
Practice Address - Fax:407-209-3541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility